Oral Pathology
Jose A. Silva, BS (he/him/his)
Doctoral Candidate, University of Colorado School of Dental Medicine
Children's Hospital Colorado, Aurora, CO
University of Colorado School of Dental Medicine
Denver, Colorado, United States
Chaitanya P. Puranik, BDS, MS, MDS, PhD
Assistant Professor and Director of Predoctoral Education
University of Colorado School of Dental Medicine, Aurora, CO, USA
Children's Hospital Colorado and School of Dental Medicine, University of Colorado Anschutz Medical Campus
Aurora, Colorado, United States
Andrew Stubbs, DMD
Creekside Endodontics
Catherine M. Flaitz, DDS, MS
Chair/ Professor
University of Colorado School of Dental Medicine
Aurora, Colorado, United States
Chaitanya P. Puranik, BDS, MS, MDS, PhD
Assistant Professor and Director of Predoctoral Education
University of Colorado School of Dental Medicine, Aurora, CO, USA
Children's Hospital Colorado and School of Dental Medicine, University of Colorado Anschutz Medical Campus
Aurora, Colorado, United States
Catherine M. Flaitz, DDS, MS
Chair/ Professor
University of Colorado School of Dental Medicine
Aurora, Colorado, United States
Introduction: The prevalence and type of orodental anomalies in children are commonly associated with cleft phenotypes in children. This case report describes rare dental anomalies observed in a child with a nonsyndromic orofacial cleft along with an innovative treatment approach.
Case report: This 12-year-old Hispanic female presented with delayed eruption of a macrodontic, and malformed, right maxillary central incisor adjacent to an alveolar cleft. Significant history included lip surgeries, hearing loss with aids and interceptive orthodontic treatment. Routine intra- and extra-oral radiographs revealed generalized radiculomegaly. The affected side had multiple primary and permanent supernumerary teeth, tooth rotation, mild root blunting, and macrodontia of right central incisor with fusion of two supernumeraries while the contralateral side, had agenesis of the first premolar. Following CBCT evaluation, surgical separation of the fused supernumeraries necessitated root canal treatment of the central incisor and future need for alveolar bone grafting.
Conclusion: Innovative and multidisciplinary treatment of orodental anomalies in our nonsyndromic orofacial cleft patient will provide strategies for management of such cases in a pediatric office. Multiple dental anomalies including generalized radiculomegaly and aberrant odontogenesis seen in our case may provide future insight into the genetic basis for phenotypic variations in nonsyndromic orofacial cleft cases.